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Contact dermatitis in children: 6 years experience (1992-1997)
1Allergy Department, Hospital Clínico, Barcelona, Spain.
Insights
Patch testing on 141 children identified nickel, cobalt, and mercurials as common allergens causing eczema. Occupational exposures were noted in adolescents, with contact dermatitis being the most frequent diagnosis.
Area of Science:
- Allergy and Immunology
- Dermatology
- Pediatric Medicine
Background:
- Patch testing is crucial for diagnosing allergic contact dermatitis in children.
- Eczema in children can stem from various environmental exposures.
- Understanding common allergens is key to effective management.
Purpose of the Study:
- To analyze patch test results in pediatric patients over a 6-year period.
- To identify the most frequent allergens and eczema localizations in children.
- To determine the diagnostic yield of patch testing in pediatric dermatology.
Main Methods:
- Patch testing was performed on 141 children using standard series and specific allergens (metallic mercury, medicaments, cosmetics, plants, shoes).
- Data collected included allergen relevance, eczema location, and suspected causes.
- Diagnostic outcomes were categorized into contact dermatitis, atopic dermatitis, and juvenile plantar dermatitis.
Main Results:
- Nickel, cobalt, mercurials, fragrance, and rubber chemicals were the most frequent allergens.
- Common eczema sites included feet, face, and hands, often linked to jewelry, footwear, and cosmetics.
- Contact dermatitis was the primary diagnosis (45%), followed by atopic dermatitis (25%).
Conclusions:
- Patch testing is valuable in identifying allergens responsible for pediatric eczema.
- Nickel and cobalt are significant allergens in children, necessitating awareness in product formulation.
- Occupational exposures should be considered in adolescents presenting with relevant positive patch tests.
Abstract:
We report the results of patch tests carried out over the last 6 years (1992 1997) on 141 children. This corresponds to 2.8% of the total patients who were patch tested in our Allergy Department (5,014). These 141 children were patch tested using the TRUE Test standard series and an additional allergen, metallic mercury. Allergens from the Chemotechnique medicaments, cosmetics, plants and shoe series were added in some. The most frequent localization of eczema was to the feet, face and hands and the most frequent suspected causes were costume jewelry, footwear, topical medicaments and cosmetics. The most frequent allergens, assessed by degree of relevance, were first, nickel, followed by cobalt, mercurials (thimerosal and metallic mercury), fragrance and rubber chemicals (naphthyl mix, mercapto mix, carba mix and PPD mix). 13 children, 18% of the total, between the ages of 12 and 14 years, showed positivities relevant to some occupation, i.e., metalworking, building, hairdressing, catering, etc. Once patch tests had been carried out and relevant positive patch tests assessed, the most frequent diagnoses were contact dermatitis 45%, atopic dermatitis 25%, juvenile plantar dermatitis 15%, and other diagnoses in the remaining 15%.